If not employed, please enter your occupation as none.
If retired, please enter retired.
You may enter N/A in the address fields below.
Do not leave Employer field blank.
By typing my name in the first and last name fields above I am indicating
my intent to sign this authorization to make this contribution utilizing
this credit card.
To comply with state law, we must use best efforts to obtain your
name, address, occupation, employer, and employer’s address.